Can Doctors Afford to Retire Early – TODAY?

By Staff Reporters

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You’ve got a sense of your ideal retirement age. And you’ve probably made certain plans based on that timeline. But what if you’re forced to retire sooner than you expect? Aging baby-boomers, corporate medicine, the medical practice great resignation and/or the pandemic, etc?

RESIGNATION: https://medicalexecutivepost.com/2021/12/12/healthcare-industry-hit-with-the-great-resignation-retirement/

Early retirement is nothing new, but it’s clear how much the COVID-19 pandemic has affected an aging workforce. Whether due to downsizing, objections to vaccine mandates, concerns about exposure risks, other health issues, or the desire for more leisure time, the retired general population grew by 3.5 million over the past two years—compared to an annual average of 1 million between 2008 and 2019—according to the Pew Research Center.1 At the same time, a survey conducted by the National Institute on Retirement Security revealed that more than half of Americans are concerned that the COVID-19 pandemic has impacted their ability to achieve a secure retirement.2

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There’s no need to panic, but those numbers make one thing clear, says Rob Williams, managing director of financial planning, retirement income, and wealth management for the Schwab Center for Financial Research. Flexible and personalized financial planning that addresses how you’d cope if you had to retire early can help you make the best use of all your resources. 

So – Here are six steps to follow. We’ll use as an example a person who’s seeing if they could retire five years early, but the steps remain the same regardless of your individual time frame.

Step 1: Think strategically about pension and Social Security benefits

For most retirees, Social Security and (to a lesser degree) pensions are the two primary sources of regular income in retirement. You usually can collect these payments early—at age 62 for Social Security and sometimes as early as age 55 with a pension. However, taking benefits early will mean that you get smaller monthly benefits for the rest of your life. That can matter to your bottom line, even if you expect Social Security to be merely the icing on your retirement cake.

On the Social Security website, you can find a projection of what your benefits would be if you were pushed to claim them several years early. But if you’re part of a two-income couple, you may want to make an appointment at a Social Security office or with a financial professional to weigh the potential options.

For example, when you die, your spouse is eligible to receive your monthly benefit if it’s higher than his or her own. But if you claim your benefits early, thus receiving a reduced amount, you’re likewise limiting your spouse’s potential survivor benefit.

If you have a pension, your employer’s pension administrator can help estimate your monthly pension payments at various ages. Once you have these estimates, you’ll have a good idea of how much monthly income you can count on at any given point in time.

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Step 2: Pressure-test your 401(k)

In addition to weighing different strategies to maximize your Social Security and/or pension, evaluate how much income you could potentially derive from your personal retirement savings—and there’s a silver lining here if you’re forced to retire early. 

Rule of 55

Let’s say you leave your job at any time during or after the calendar year you turn 55 (or age 50 if you’re a public safety employee with a government defined-benefit plan). Under a little-known separation-of-service provision, often referred to as the “rule of 55,” you may be able take distributions (though some plans may allow only one lump-sum withdrawal) from your 401(k), 403(b), or other qualified retirement plan free of the usual 10% early-withdrawal penalties. However, be aware that you’ll still owe ordinary income taxes on the amount distributed. 

This exception applies only to the plan (including any consolidated accounts) that you were contributing to when you separated from service. It does not extend to IRAs. 

4% rule

There’s also a simple rule of thumb suggesting that if you spend 4% or less of your savings in your first year of retirement and then adjust for inflation each year following, your savings are likely to last for at least 30 years—given that you make no other changes to your withdrawals, such as a lump sum withdrawal for a one-time expense or a slight reduction in withdrawals during a down market. 

To see how much monthly income you could count on if you retired as expected in five years, multiply your current savings by 4% and divide by 12. For example, $1 million x .04 = $40,000. Divide that by 12 to get $3,333 per month in year one of retirement. (Again, you could increase that amount with inflation each year thereafter.) Then do the same calculation based on your current savings to see how much you’d have to live on if you retired today. Keep in mind that your money will have to last five years longer in this instance.

Knowing the monthly amount your current savings can generate will give you a clearer sense of whether you’ll have a shortfall—and how large or small it might be. Use our retirement savings calculator to test different saving amounts and time frames.

Step 3: Don’t forget about health insurance, doctor!

Nobody wants to spend down a big chunk of their retirement savings on unanticipated healthcare costs in the years between early retirement and Medicare eligibility at age 65. If you lose your employer-sponsored health insurance, you’ll want to find some coverage until you can apply for Medicare. 

Your options may include continuing employer-sponsored coverage through COBRA, insurance enrollment through the Health Insurance Marketplace at HealthCare.gov, or joining your spouse’s health insurance plan. You may also find discounted coverage through organizations you belong to—for example, the AARP. 

Step 4: Create a post-retirement budget

To make sure your retirement savings will cover your expenses, add up the monthly income you could get from pensions, Social Security, and your savings. Then, compare the total to your anticipated monthly expenses (including income taxes) if you were to retire five years early and are eligible, and choose to file, for Social Security and pension benefits earlier. 

Take into account various life events and expenditures you may encounter. You may not pay off your mortgage by the date you’d planned. Your spouse might still be working (which can add income but also prolong certain expenses). Or your children might not be out of college yet. 

You’re probably fine if you anticipate that your monthly expenses will be lower than your income. But if you think your expenses would be higher than your early-retirement income, some suggest that you take one or more of these measures:

  • Retire later; practice longer.
  • Save more now to fill some of the potential gap.
  • Trim your budget so there’s less of a gap down the road.
  • Consider options for medical consulting or part-time work—and begin to explore some of those opportunities now.

To the last point, finding a physician job later in life can be challenging, but certain employment agencies specialize in this area. If you can find work you like that covers a portion of your expenses, you’ll have the option of delaying Social Security and your company pension to get higher payments later—and you can avoid dipping into your retirement savings prematurely. 

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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Step 5: Protect your portfolio

When you retire early, you have to walk a fine line with your portfolio’s asset allocation—investing aggressively enough that your money has the potential to grow over a long retirement, but also conservatively enough to minimize the chance of big losses, particularly at the outset.

“Risk management is especially important during the first few years of retirement or if you retire early,” Rob notes, because it can be difficult to bounce back from a loss when you’re drawing down income from your portfolio and reducing the overall number of shares you own.  

To strike a balance between growth and security, start by making sure you have enough money stashed in relatively liquid, relatively stable investments—such as money market accounts, CDs, or high-quality short-term bonds—to cover at least a year or two of living expenses. Divide the rest of your portfolio among stocks, bonds, and other fixed-income investments. And don’t hesitate to seek professional help to arrive at the right mix. 

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Many people are unaccustomed to thinking about their expenses because they simply spend what they make when working, Rob says. But one of the most valuable decisions you can make about your life in retirement is to reevaluate where your money is going now.

This serves two aims. First, it’s a reality check on the spending plan you’ve envisioned for retirement, which may be idealized (e.g., “I’ll do all the home maintenance and repairs!”). Second, it enables you to adjust your spending habits ahead of schedule—whichever schedule you end up following. This gives you more control and potentially more income. 

Step 6: Reevaluate your current spending

For example, if you’re not averse to downsizing, moving to a less expensive home could reduce your monthly mortgage, property tax, and insurance payments while freeing up equity that could also be invested to provide additional monthly income.

“When you are saving for retirement, time is on your side”. You lose that advantage when you’re forced to retire early, but having a backup plan that anticipates the possibility of an early retirement can make the unknowns you face a lot less daunting.

CITE: https://www.r2library.com/Resource/Title/082610254

References:

1Richard Fry, “Amid the Pandemic, A Rising Share Of Older U.S. Adults Are Now Retired”, Pew Research Center, 11/04/2021, https://www.pewresearch.org/fact-tank/2021/11/04/amid-the-pandemic-a-rising-share-of-older-u-s-adults-are-now-retired/.

2Tyler Bond, Don Doonan and Kelly Kenneally, “Retirement Insecurity 2021: Americans’ Views of Retirement”, Nirsonline.Org, 02/2021, https://www.nirsonline.org/wp-content/uploads/2021/02/FINAL-Retirement-Insecurity-2021-.pdf.

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What is the plan for a future with COVID?

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Q: What is the plan for a future with COVID?
A:
A new 136-page report written by dozens of experts provides a comprehensive roadmap to the next normal both to address the pandemic and protect against future biosecurity threats. The group identified 12 key areas of focus, including long COVID, equity, and vaccines. The report also addressed concerns about how the end of the pandemic will disrupt the U.S. health care system when policies introduced during the public health emergency come to an end. 

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Update on COVID-19 Booster Shots

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Update on COVID-19 booster shots
In case you missed it: If you or a loved one are 50 or older, or are moderately or severely immunocompromised, you can get an additional Pfizer or Moderna COVID-19 booster shot at no cost to you.

The CDC recommends an additional booster shot for certain individuals to increase protection from severe disease from COVID-19. People over the age of 50, or who are moderately or severely immunocompromised, can get an additional booster of Pfizer or Moderna 4 months after their last dose.

This is especially important for those 65 and older who are at higher risk from severe disease and most likely to benefit from getting an additional booster.

Learn More: Remember: Medicare covers the COVID-19 vaccine, including booster shots, at no cost to you. Find a COVID-19 vaccine location near you.

Sincerely
The Medicare Team

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MORE: https://www.medicare.gov/medicare-coronavirus?utm_campaign=20220406_cvd_prv_gal&utm_content=english&utm_medium=email&utm_source=govdelivery

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PODCAST: Medical Supply Chain Management?

Our broken healthcare supply chain – what can be done

By Dr. Marion Mass MD

Dr. Marion Mass graduated from Medical School at Duke University. She completed internship and residency at Northwestern University’s Robert Lurie Children’s Hospital in Chicago. Dr. Mass has worked in the Philadelphia area as a pediatrician for 21 years.

Fixing Common Medical Device Supply Chain Break Points - # ...

PODCAST: https://www.youtube.com/watch?v=-BZEVnkkRAE

MARCINKO on SCM: https://medicalexecutivepost.com/2011/06/09/supply-chain-management-in-healthcare/

Your comments are appreciated.

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UPDATE: The Stock Markets and IRS Online Taxpayer ID

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By Staff Reporters

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MARKETS: The S&P 500 fell into a correction for the first time in two years, joining the NASDAQ Composite, as Russia sent troops into pro-Russian regions in Ukraine. The S&P 500 index ended down 1% at 4,304.76, below the correction level at 4,316.91, which would represent a 10% drop from its January 3rd record close. A correction is commonly defined by market technicians as a fall of at least 10% (but not greater than 20%) from a recent peak. The last time the S&P 500 entered a correction was February 27th 2020, when the market was being whipsawed by fears about the outbreak of the COVID pandemic.

And, this bearish market isn’t sparing 2021 winners like Home Depot, which fell the most in nearly two years after supply-chain bottlenecks squeezed its margins. HD was the Dow’s biggest gainer last year.

CITE: https://www.r2library.com/Resource/Title/0826102549

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IRS: According to a news release issued by the IRS, taxpayers now have the option to verify their identities during live, virtual interviews with agents. The agency stresses that no bio-metric data will be required for those interviews.

However, taxpayers once again have the option to verify their identity using ID.me’s facial recognition services. Addressing privacy concerns, the IRS says new requirements are in place to ensure that images provided will be deleted upon verification. That would apply to any new IRS accounts created and those where selfies have already been collected.

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ENDEMIC: Definitions for Related Terms

By Staff Reporters

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Endemic: A constant presence and/or usual prevalence of a disease or infection, such as the Corona virus, within a geographic area. (Hyperendemic is a situation in which there are persistent high levels of disease occurrence.)

MORE: https://www.health.com/condition/infectious-diseases/coronavirus/what-is-an-endemic-virus

As opposed to the terms epidemic, pandemic and sporadic.

RELATED: https://medicalexecutivepost.com/2022/01/13/pandemic-versus-epidemic/

Seasonal Flu: https://www.msn.com/en-us/money/smallbusiness/bill-gates-is-releasing-a-new-book-about-how-to-avoid-another-pandemic-heres-what-we-know/ar-AATFjcO?li=BBnbfcL

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How can the world adapt to Covid-19 in the long term? | News | Wellcome

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UPDATE: Stock Markets, the Economy and Pandemic

By Staff Reporters

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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  • Stock Markets: US stocks staged a big afternoon comeback for the second day in a row … but still not big enough to close in the green. American Express was the top performer in both the S&P and the Dow after the company reported its highest billings volume ever in Q4. And, enthusiasm over meme stocks more broadly appears to be dwindling along with cryptos. And, while NASDAQ took a hit, Microsoft reported quarterly sales of more than $50 billion for the first time ever.
  • Economy: The weight of the financial world is on Jerome Powell’s shoulders today. The Federal Reserve chair will provide an update on the central bank’s views on sky-high inflation and its plan for interest rate hikes this year (though none are expected until March).
  • Pandemic: Pfizer and BioNTech started clinical trials for an Omicron-specific vaccine yesterday. The results will help the pharma partners decide whether to replace their current jab formula with one that targets the most dominant Covid variant. The new vaccine is being tested both as a three-shot series for un-vaccinated participants and as a booster for the already vaccinated.
  • CITE: https://www.r2library.com/Resource/Title/082610254

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PODCAST Year End 2021: Rich Helppie Interviews Dr. James R. Baker, Jr., M.D.

The Common Bridge

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Entering the Last Chapter of Covid, From Omicron and Beyond – With Dr. James R. Baker, Jr., M.D.
Richard Helppie welcomes back University of Michigan Professor Emeritus of Internal Medicine, and Virologist, Dr. James R. Baker, Jr., M.D., who brings words of both encouragement and warning as the world comes to what he feels is the beginning of the final throws of the Covid-19 pandemic. 

Dr. Baker has been a valued guest on the Common Bridge since the beginnings of the coronavirus over a year ago, and brings thoughtful, scientific, data-driven analysis to the most significant health issue of our lifetime.

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PODCAST: https://richardhelppie.com/james-baker/

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66% of Nurses Expressed Consideration to Leave The Profession

By staff reporters

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66% of Nurses Expressed Consideration to Leave The Profession

A survey of 570 nurses between May and June 2021 found:

 •  66% of nurses expressed some level of consideration to leave the profession.
 •  97% of polled participants agree, that increases to pay rates and other incentives would attract and retain nurses.
 •  58% agree that tele-health should be a cornerstone of care delivery.
 •  85% believe that we must improve cross training to adapt to crisis events.
 •  85% strongly believe national licensure would have greatly benefited the country during the pandemic.

Source: Cross Country Healthcare via Businesswire, December 1, 2021

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Face Masks and Human Sneezes

Now – Do You Get It?

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OMICRON UPDATE: https://www.msn.com/en-us/health/medical/us-coronavirus-omicron-will-not-recognize-state-lines-when-it-storms-the-us-expert-says/ar-AAS1302?li=BBnb7Kz

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The Bear MARKETS and Cyber ECONOMY

By Staff Reporters

  • Markets: Stocks dropped sharply in the post-Thanksgiving trading session on Friday due to concerns over the new Covid variant, Omicron. The Dow fell 2.5% for its worst day of the year, and the S&P also tumbled 2.3%. Oil prices and travel stocks also got rocked given fresh worries over travel demand, while “stay-at-home” names like Peloton and Zoom got a boost.
See the source image
  • Economy: It’s still way too early to know the impact of Omicron on economic growth. As we laid out last week, the Fed is under pressure to accelerate the winding down of its stimulus measures in order to battle inflation, but the new variant could change the calculus. Investors dialed back their expectations of a sooner-than-expected rate increase on Friday.

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Why the Stock Markets CRASHED TODAY [9/20/21]?

Feel Free to Add to the Our Growing List of Reasons!

BUT REMEMBER THAT CORRELATION IS NOT CAUSATION

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BY DR. DAVID E. MARCINKO MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Chart: The Worst Stock Market Crashes of the 21st Century | Statista

THE LIST GOES ON

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China’s Evergrande Project Giant Contagion Jitters

Global and International Market Meltdowns

Crypto-Currency and Gas Price Tumbles

Depressed Automobile Rentals and Used Car Prices

Lowering US Treasury Bond Yields

US Debt Ceiling Risks and Looming Federal Shutdown

Travel Bans with Mask & Vaccine Debates During the Corono-Virus Pandemic

The $3.5 Trillion Dollar Senate Bill

Politics and Potential Federal Tax Law Changes

The National Park, Pacific North-West and California Wild Fires

The Weather, Flooding, Tornadoes, Hurricanes and Tropical Storms

Southern Border Immigration Crisis

A Dearth of Micro-Chips

Quadruple Witching Friday

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CORRECTION? https://www.msn.com/en-us/money/markets/the-odds-of-a-20-correction-in-stocks-are-rising-as-the-market-transitions-to-the-next-stage-of-its-cycle-morgan-stanley-warns/ar-AAODytg

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Feel free to add to our list.

Is this the start of a cyclical bear market?

MORE: https://medicalexecutivepost.com/2018/12/22/stocks-and-sectors-in-bear-territory/

RELATED: https://medicalexecutivepost.com/2016/03/18/doctors-and-bull-and-bear-markets/

MORE: https://medicalexecutivepost.com/2007/11/25/of-bull-and-bear-markets/

EVERGRANDE: https://www.msn.com/en-us/money/markets/evergrande-s-debt-crisis-has-jolted-the-stock-market-here-s-why-everyone-s-suddenly-worrying-about-china-s-2nd-largest-property-developer/ar-AAODW0q

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COMMUNITY MASKING: The Impact on COVID-19

A Cluster-Randomized Trial in Bangladesh

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Freudenberg's surgical masks get FDA clearance

LINK: https://www.poverty-action.org/sites/default/files/publications/Mask_RCT____Symptomatic_Seropositivity_083121.pdf

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MORE: https://www.msn.com/en-us/news/world/us-records-40-million-known-virus-cases/ar-AAOaN08?li=BBnb7Kz

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PODCAST: The ‘Weaponization’ Of The CV19 Vaccine?

DR. JOHN TRAVIS MD MPH

John W. “Jack” Travis, MD, MPH, completed his medical degree at Tufts University and a residency in preventive medicine at Johns Hopkins, where he received a Masters in Public Health and created one of the first computerized Health Risk Assessments (HRAs).

Dr. Jack joins colleague Pete R. Peter R. Quinones to describe what he refers to as the “weaponization of vaccines” and specifically concentrates on the CV19 “vaccines”.

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COVID-19 Information | Peachtree Corners, GA

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PODCAST: https://freemanbeyondthewall.libsyn.com/episode-586

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Study Finds COVID-19 Accelerated Physician Practice Acquisitions

Study Finds COVID-19 Accelerated Physician Practice Acquisitions

By Health Capital Consultants, LLC


A recent study from Physicians Advocacy Institute (PAI), prepared by Avalere Health, associated the growing number of both physician practice acquisitions and employed physicians between 2019 and 2021 with the COVID-19 pandemic.

To study COVID-19’s impact on physician employment trends, the June 2021 study evaluated the IQVIA OneKey database that contains physician practice and health system ownership information.

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To assess these trends at a national and regional level, Avalere researchers studied the two-year period from January 1, 2019 to January 1, 2021. (Read more…)

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PODCAST: What Exactly is a Human Sneeze?

All About “STERNUTATION”

Courtesy: www.CertifiedMedicalPlanner.org

A Silly Question Until Covid-19!

A “Sternutation” is a sudden involuntary expulsion of air from the lungs through the nose and mouth due to irritation of the nasal passage.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

A sneeze is not always related to an underlying medical condition. It may be caused by:

  • Nasal irritants (dust, pepper, pollen etc)
  • Sudden exposure to bright light
  • Breathing cold air
  • Object struck in nose.

Self-treatment helpful in some less- serious cases include:

  • Change the furnace or air conditioner filters
  • Do not have pets in the house if allergic to animal dander
  • Wash linens in very hot water (at least 130 degrees Fahrenheit) to kill dust mites
  • Vacuum and dust frequently
  • Use a good humidifier especially at night, if the air is too dry
  • Drink plenty of water if suffering from flu/common cold.

See a doctor if you notice the following :

  • Fever greater than 101.3 F (38.5 C)
  • Fever lasting five days or more or returning after a fever- free period
  • Shortness of breath
  • Wheezing
  • Severe sore throat, headache or sinus pain
  • Allergy does not resolves in a few days.

See a doctor immediately if you notice:

  • Sneezing is continuous
  • Causes severe ear pain, drowsiness.

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PODCAST: https://www.bing.com/videos/search?q=sneeze&&view=detail&mid=C4DA4CD281B4AD36C2A5C4DA4CD281B4AD36C2A5&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3Dsneeze%26FORM%3DHDRSC3

VIDEO: https://www.msn.com/en-us/video/science/see-how-a-mask-affects-how-a-cough-travels/vi-BB13AQBH?ocid=SK2LDHP

Assessment: Your thoughts and comments are appreciated.

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BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

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COVID-19 Financial Resources for Physicians

Bhagwan Satiani, MD, MBA, DFSVS, FACHE, FACS

Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA

Jessica L. Bailey-Wheaton, JD

ABSTRACT

The appropriate focus in managing the COVID-19 pandemic in the United States has been addressing access and delivery of care to the population affected by the outbreak. All sectors of the U.S. economy have been significantly affected,including physicians. Physician groups of all specialties and sizes have experienced the financial effects of the pandemic.Hospitals have received billions of dollars to support and enable them to manage emergencies and cover the costs of the disruption.

However, many vascular surgeons are under great financial pressure because of the postponement of all non-emergency procedures. The federal government has announced a myriad of programs in the form of grants and loans to reimburse physicians for some of their expenses and loss of revenue. It is more than likely that unless the public health emergency subsides significantly, many practices will experience dire consequences without additional financial assistance.

The authors have attempted to provide a concise listing of such programs and resources available to assist vascular surgeons who are small businesses in accessing these opportunities.

Health Capital Consultants - Healthcare Valuation

WHITE PAPER: https://www.healthcapital.com/researchmaterialdocuments/publishedarticles/Journal%20of%20Vascular%20Surgery%205.8.20.pdf

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PODCAST: The Covid 19 Pandemic and Mental Health

Including Substance Use Issues

By Dr. David E. Marcinko MBA CMP© and staff reporters

The COVID-19 pandemic has spurred—and aggravated—a range of mental health and substance use issues in the United States.

In this episode of Critical Point, Milliman’s Stoddard Davenport discusses the rising demand for mental health services and how different populations are being affected. Stoddard also highlights recent statistics on the topic and what the road ahead may look like for mental health in America.

PODCAST LINK: https://www.healthcaretownhall.com/?p=10186

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Community Mental Health Programs and Resources: https://healthcarefinancials.files.wordpress.com/2019/05/mental-health-dr.-marcinko.pdf

Social Determinant of Health: https://www.healthsharetv.com/content/webinar-recap-social-determinants-health-turning-potential-actual-value

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What is the Current Rate of Return [CRR] for Your [Pandemic] Investments?

THE INVESTING “CURRENT RATE OF RETURN

By Dr. David Edward Marcinko MBA CMP®

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SPONSORED: http://www.CertifiedMedicalPlanner.org

Stock Market Pandemic History

Technology stocks have largely been in favor since the COVID-19 pandemic began, but re-openings in the U.S. and elsewhere as vaccines take hold have pushed investors toward value stocks, which are geared more toward the economy. But lately, stronger growth expectations are also sparking worries of higher inflation, and a potential tapping of the brakes by central banks.

Therefore, an important concept for physicians and all investors to understand is the Current Rate of Return (CCR).

So, What Exactly is CRR?

According to this principle, the current rate of a taxable return must be evaluated in reference to a similar non-taxable rate of return. This allows you to focus on your portfolio’s real (after-tax return), rather than its’ nominal, or stated return. Since most medical professionals own a combination of both vehicles, it is important to calculate the average rate of return (ARR), as demonstrated in the following matrix. Usually, this will result in the assumption of more risk, for the possibility of great return.

To compare after tax yields, with taxable yields, use the following formulas:

Tax equivalent yield = yield / (1 – MTB), while taxable yield X (1-tax rate) = tax exempt yield.

Example: if the yield on a tax exempt municipal bond was 6%, and you are in a 28% tax bracket; the equivalent taxable yield (ETY), is 8.3%, calculated in the following manner: 06 / 1.00 – .28 =.083, or, 8.3% ETY.

This means that you would need a taxable instrument paying almost 9 % to equal the 6 percent tax exempt bond.   

ASSESSMENT: Your thoughts are appreciated.    

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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How the Vaccines Work?

PFIZER-BioNTech and MODERNA

By staff reporters

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The Pre-Vaccine Era

ESTIMATED ANNUAL MORBIDITY IN THE USA

By staff reporters

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The Pandemic and Long Term Care Facilities

COVID-19 and Long Term Care Facilities

By http://www.MCOL.com

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Covid-19 Test Accuracy?

UPDATE

By staff reporters

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Corona Virus [Pictorial] Update?

An Info-Graphic?

By Staff Reporters

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THE “Corona Class Room”

Safety Measures to Date?

By Anonymous

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Physician Practices Weathering the Storm of COVID-10?

Physician Practices Weathering the Storm of COVID-10?

By staff reporters

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How Did We Screw Up the Pandemic So Badly?

By Bertalan Mesk MD PhD

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https://www.linkedin.com/pulse/how-did-we-screw-pandemic-up-so-bad-bertalan-mesk%C3%B3-md-phd/?trk=eml-email_series_follow_newsletter_01-hero-257-title_link&midToken=AQGGg4QStFgVOA&fromEmail=fromEmail&ut=0zs6pcrWG-_9o1

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ANOSMIA, HYPERSOMIA, AGEUSIA, HYPOGEUSIA, DYSGEUSIA and the CORONA VIRUS?

WHAT IS “ANOSMIA”

By Darrell Pruitt DDS and David E. Marcinko MBBS, MBA

Anosmia, also known as smell blindness, is the loss of the ability to detect one or more smells. Anosmia may be temporary or permanent. It differs from Hyposmia which is a decreased sensitivity to some or all smells.

According to Wikipedia, Anosmia can be due to a number of factors, including an inflammation of the nasal mucosa, blockage of nasal passages or a destruction of one temporal lobe. Inflammation is due to chronic mucosa changes in the lining of the paranasal sinus and in the middle and superior turbinates. When anosmia is caused by inflammatory changes in the nasal passageways, it is treated simply by reducing inflammation. It can be caused by chronic meningitis and neurosyphilis that would increase intracranial pressure over a long period of time, and in some cases by ciliopathy, including ciliopathy due to primary ciliary dyskinesia. The term derives from the New Latin anosmia, based on Ancient Greek ἀν- (an-) + ὀσμή (osmḗ, “smell”; another related term, hyperosmia, refers to an increased ability to smell). Some people may be anosmic for one particular odor, a condition known as “specific anosmia”. The absence of the sense of smell from birth is known as congenital anosmia.

Ageusia is the loss of taste functions of the tongue, particularly the inability to detect sweetness, sourness, bitterness, saltiness, and umami. It is sometimes confused with anosmia – a loss of the sense of smell. Because the tongue can only indicate texture and differentiate between sweet, sour, bitter, salty, and umami, most of what is perceived as the sense of taste is actually derived from smell. True Ageusia is relatively rare compared to Hypogeusia – a partial loss of taste – and Dysgeusia – a distortion or alteration of taste.

ASSESSMENT:

If you should suddenly lose your sense of smell (anosmia), you might want to get tested for COVID-19 – even without the presence of other symptoms.

“A majority of COVID-19 patients experience some level of anosmia, most often temporary. Analyses of electronic health records indicate that COVID-19 patients are 27 times more likely to have smell loss but are only around 2.2 to 2.6 times more likely to have fever, cough or respiratory difficulty, compared to patients without COVID-19.”

See: “How COVID-19 Causes Loss of Smell – Olfactory support cells, not neurons, are vulnerable to novel coronavirus infection.” By Kevin Jiang for Harvard Medical School, July 24, 2020.

https://hms.harvard.edu/news/how-covid-19-causes-loss-smell

Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

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COVID-19 Testing and Mortality Update

INFOGRAPHICS

By staff reporters

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Corona Virus Human Isolation Bubbles

BACK TO THE FUTURE

By Anonymous

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Healthcare and the Pandemic

Click to access AMCP-ACHP-Consumer-Polling-Data.pdf

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